Tantam Medical Group, Inc.

LBN: Tantam Medical Group, Inc.
Tantam Medical Group, Inc. is an health care organization with primary practice located at 1610 W Edinger Ave Ste B , Santa Ana CA 92704-4339. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Tantam Medical Group, Inc. can be contacted via phone (714) 641-1610, or through Tantamjarik, Pumipak via phone (714) 641-1610.

Contact Information

Primary practice address
1610 W Edinger Ave Ste B Santa Ana CA 92704-4339
Phone: (714) 641-1610
Fax: (714) 641-1146
Website:
Map and Directions
Authorized official contact:
Name: Tantamjarik, Pumipak MD, FAAFP
Phone: (714) 641-1610

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A71362 California
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A31595 California
Allopathic & Osteopathic Physicians / General Practice 208D00000X A31442 California

Profile Details

NPI number 1154315828
LBN Legal business name Tantam Medical Group, Inc.
DBA Doing business as
Authorized official Tantamjarik, Pumipak MD, FAAFP
Entity Organization
Organization subpart 1 No
Enumeration date Sep 8th, 2005
Last updated Feb 23rd, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154315828 NPPES
California MEDICAID GR0027840

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